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Myasthenia Gravis: Overview and Treatment01:20

Myasthenia Gravis: Overview and Treatment

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Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
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Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

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Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
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Myasthenia Gravis: Diagnostic Tests01:15

Myasthenia Gravis: Diagnostic Tests

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Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
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Direct-Acting Cholinergic Agonists: Therapeutic Uses01:11

Direct-Acting Cholinergic Agonists: Therapeutic Uses

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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
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Cholinergic Receptors: Muscarinic01:25

Cholinergic Receptors: Muscarinic

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The pharmacological actions of acetylcholine are elicited via its binding to two families of cholinergic receptors or cholinoceptors, namely, muscarinic and nicotinic receptors. Muscarinic receptors are G protein-coupled receptors and have five subtypes, M1–M5. All mAChR subtypes are activated by acetylcholine and blocked by the antagonist, atropine. 
The subtypes M1, M3, and M5 couple with the Gq subunit and activate the phospholipase C (PLC) activity, mobilizing intracellular Ca2+....
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Related Experiment Video

Updated: Jan 4, 2026

A 3D System for Culturing Human Articular Chondrocytes in Synovial Fluid
09:58

A 3D System for Culturing Human Articular Chondrocytes in Synovial Fluid

Published on: January 31, 2012

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Cholinergic synovitis: Description of four cases.

Carlos Guillén Astete1, Miguel Zamorano Serrano2, Mónica Luque Alarcón3

  • 1Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España.

Reumatologia Clinica
|November 12, 2019
PubMed
Summary

Four athletes experienced joint swelling and skin rashes during warm-weather sports. Hydroxychloroquine treatment improved symptoms, suggesting a link to heat-induced cholinergic urticaria affecting the synovium.

Keywords:
Cholinergic synovitisCholinergic urticariaEcografía articularFisiología sinovialJoint ultrasoundSinovitis colinérgicaSynovial physiologyUrticaria colinérgica

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Area of Science:

  • Rheumatology
  • Dermatology
  • Sports Medicine

Background:

  • Urticarial skin lesions and synovitis are uncommon co-occurrences in athletes.
  • Sports activity in warm environments may trigger unique physiological responses.
  • Cholinergic urticaria is a known condition characterized by hives due to heat or exercise.

Observation:

  • Four patients presented with moderate synovitis and urticarial skin lesions.
  • Symptoms were associated with sports activities performed in warm environmental conditions.
  • Clinical and ultrasound findings documented the synovitis and skin manifestations.

Findings:

  • A potential causal relationship between physical exertion in heat and these symptoms is proposed.
  • The condition appears analogous to cholinergic urticaria, with synovial effusion as a related response.
  • Symptoms self-limited after halting the triggering activity.

Implications:

  • This suggests a novel presentation of heat- or exercise-induced urticarial synovitis.
  • Hydroxychloroquine may be an effective treatment for this condition.
  • Further research is warranted to elucidate the pathophysiology and confirm the proposed causal link.